Vitamin D
Vitamin D supplementation is a common topic among headache disorders. Prior research has linked Vitamin D deficiency to various types of headaches, including migraines, tension headaches, and cluster headaches.1-3 Vitamin D deficiency is defined as a level <20 ng/mL. Recently, a research letter in Headache was published assessing if there was a difference in vitamin D levels among those with cluster headaches and those without. They reported there was no significant difference between the two groups (26.3 (± 1x0.7) and 26.6 (± 12.6) ng/mL, respectively, (95% confidence interval, −4.208 to 3.642; p = 0.887)).4 Notably, both groups were characterized by Vitamin D insufficiency (<30 ng/ml).
The issue of insufficient Vitamin D levels is becoming increasingly recognized as a global health challenge, impacting roughly 30–80% of children and adults.5 Vitamin D performs multiple roles, reducing inflammation, impacting immune systems, regulating cell growth, and controlling the neuromuscular system.6 Its deficiency is associated with various conditions like infections, musculoskeletal issues, autoimmune diseases, diabetes, cardiovascular problems, neurological and cognitive function, psychiatric disorders, and heightened cancer risk.7, 8 However, an exact underlying mechanism for these mentioned connections has not been fully explained. Inflammation plays a key role in headaches. Therefore, it is suspected the anti-inflammatory role of vitamin D is an integral component in migraine and headaches.
Although there are no universal vitamin D screening guidelines, assessments should be obtained in situations that are suspicious for deficiency.9 Examples encompass individuals with limited oral intake, limited sun exposure, advanced age, gastrointestinal conditions (such as celiac disease and inflammatory bowel disease), and those with renal impairments. In my clinical practice, I routinely include vitamin D level assessments when ordering blood work. Taking Vitamin D 600-800 international units (IU) daily can be used to prevent vitamin D deficiency.10 Be sure to get your daily dose of sunlight! (with appropriate sunscreen of course)
References:
1. Prakash S, Rathore C, Makwana P, Dave A, Joshi H, Parekh H. Vitamin D Deficiency in Patients With Chronic Tension-Type Headache: A Case-Control Study. Headache. 2017;57:1096-1108.
2. Ghorbani Z, Togha M, Rafiee P, et al. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci. 2019;40:2459-2477.
3. Sohn J-H, Chu M-K, Park K-Y, Ahn H-Y, Cho S-J. Vitamin D deficiency in patients with cluster headache: a preliminary study. The Journal of Headache and Pain. 2018;19:54.
4. Yang M, Arbs B, Swartz K, Kovacs AJ. Vitamin D concentrations in patients with cluster headache: A matched case–control study. Headache: The Journal of Head and Face Pain.n/a.
5. Nowaczewska M, Wiciński M, Osiński S, Kaźmierczak H. The Role of Vitamin D in Primary Headache-from Potential Mechanism to Treatment. Nutrients. 2020;12.
6. Hewison M. Vitamin D and immune function: an overview. Proc Nutr Soc. 2012;71:50-61.
7. Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2:76-89.
8. Holick MF. Vitamin D and brain health: the need for vitamin D supplementation and sensible sun exposure. J Intern Med. 2015;277:90-93.
9. Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010;85:752-757; quiz 757-758.
10. Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017;13:466-479.